Effect of lidocaine ice button topical anesthesia on pain during maxillary buccal infiltration in 6-10-year children - A randomized control trial.

Context: Effective pain management in children during local anesthetic administration would be a key to a successful and painless dental procedure. Precooling (PC) has emerged as pain control tool in dentistry.

Aims: This study aims to evaluate and compare the efficacy of lidocaine Ice button and lidocaine gel as topical anesthesia during maxillary buccal infiltration in children.

Settings And Design: Randomized crossover trial, department of pediatric and preventive dentistry.

Subjects And Methods: Thirty children [60 local anesthesia (LA) injections] aged 6-10 years requiring bilateral maxillary buccal infiltration for dental procedure, divided into 2 groups with equal distribution for this split-mouth study. The study group was lidocaine ice button topical anesthesia; the control group was the lidocaine gel group. Subjective pain was evaluated using Wong-Baker Faces Pain Rating Scale, objective pain evaluation was done using Sound Eye and Motor (SEM) scale. Anxiety assessment using Venham picture test (VPT) and physiologic parameters such as SpO2 and Heart rate were evaluated before, during, and after administration of LA. Acceptance of lidocaine ice button was evaluated using a customized validated questionnaire.

Statistical Analysis Used: Data recorded in Microsoft Excel 365 and subjected to statistical analysis using Statistical Product and service solution SPSS version 21.0 with P value considered statistically significant at < 0.05.

Results: A significant reduction in pain on injection for both objective and subjective evaluations in the Lidocaine Ice Button group, as topical anesthesia was seen (P < 0.00011) Majority of the children preferred the use of Lidocaine ice button as a topical anesthetic. No difference in pain was observed in groups based on treatment sequence.

Conclusions: Less pain on injection was observed, proving the efficacy of lidocaine ice button as topical anesthesia for maxillary infiltration in the study. Lidocaine ice button was well accepted by the children as topical anesthesia.